Background: During infections, polymorphonuclear neutrophilic granulocytes (PMN) are mobilized from their bone marrow stores, travel with blood to the affected tissue, and kill invading microbes there. The signal(s) from the inflammatory site to the marrow are unknown, even though a number of humoral factors that can mobilize PMN, are well known. We have employed a standardized, non-infectious human model to elucidate relevant PMN mobilizers. Welltrained athletes performed a 60-min strenuous strength workout of leg muscles. Blood samples were drawn before, during and just after exercise, and then repeatedly during the following day. Cortisol, GH, ACTH, complement factors, high-sensitive CRP (muCRP), IL-6, G-CSF, IL-8 (CXCL8) and MIP-1β (CCL4) were measured in blood samples. PMN chemotaxins in test plasma was assessed with a micropore membrane technique.
Medisinsk avdeling Sykehuset Innlandet, Gjøvik Astrid Kravdal er spesialist i indremedisin og lungesykdommer og overlege. Forfa eren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter. Medisinsk avdeling Sykehuset Innlandet, Gjøvik Øystein Olav Stubhaug er spesialist i indremedisin og lungesykdommer og overlege. Forfa eren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter. Radiologisk avdeling Sykehuset Innlandet, Gjøvik Ruta Piekuviene er radiolog og avdelingsoverlege. Forfa eren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter. Medisinsk avdeling Sykehuset Innlandet, Gjøvik Astrid Sandnes er konstituert overlege. Forfa eren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter.
BackgroundPulmonary manifestations of tularaemia are reported to be infrequent in previous publications. During 2016, we noticed an increase in the number of hospitalised patients with pulmonary tularaemia in Eastern Norway. We aimed to investigate primary pulmonary tularaemia in Eastern Norway in terms of symptoms, radiological and microbiological findings, incidence and risk exposure.MethodsA retrospective analysis of consecutive primary pulmonary tularaemia cases from 2016 until 2018 was conducted.ResultsFrom 1 September, 2016 until 31 December, 2018, 22 patients were diagnosed with primary pulmonary tularaemia at Innlandet Hospital Trust, representing 48% of all reported tularaemia cases in the region. A peak annual incidence of 3.4 in 100 000 was found in 2017.All 22 patients lived in, or had recently visited, rural areas. Eighteen patients reported risk exposure for tularaemia, such as wood chopping, outdoor activities and farming prior to symptom onset. All patients experienced fever, and 19 patients had respiratory symptoms. Ten patients were in spontaneous recovery at diagnosis.All patients had a chest computed tomography scan. Overall, 19 patients had pulmonary lesions and 18 had enlarged intrathoracic lymph nodes. The computed tomography images were described as suspicious of malignancy in 17 patients.ConclusionPulmonary manifestations in tularaemia occurred more frequently in our region than expected from previous reports. Although all patients had symptoms consistent with infection, the majority were primarily investigated considering lung cancer due to the radiology report. In endemic areas, pulmonary tularaemia may be an important differential diagnosis to lung cancer.
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